AccountId: 011433970860
ContactId: 54918dbd-3bc4-47f2-af7d-f3d37f64cc28
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 327619 ms
Total Talk Time (AGENT): 156512 ms
Total Talk Time (CUSTOMER): 131526 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/54918dbd-3bc4-47f2-af7d-f3d37f64cc28_20250509T13:22_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I am calling because
[CUSTOMER][NEUTRAL] Um, this is the first, um, time I've needed to use the card, and I'm trying to order my diabetic supplies. I normally order through them through tandem diabetes care.
[CUSTOMER][NEGATIVE] Um, and they're telling me that they're not in network with this card, um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Because I keep running into problems. My main insurance is Blue Cross Blue Shield, and then we have you as our secondary. Um, how am I supposed to use your card? Like, is it gap insurance?
[AGENT][NEUTRAL] Um, I can check it and see the benefits and see what type you have. Um, and when you said it's gonna be for your diabetic supplies, is it like, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Medical supplies.
[CUSTOMER][NEUTRAL] Just
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, mhm, it's, it's infusion sets and cartridges for my pump.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. um, let me have a callback number just in case we get disconnected, Ms. [PII].
[CUSTOMER][NEUTRAL] Sure, um, [PII].
[AGENT][NEUTRAL] OK. And may I have the policy number?
[CUSTOMER][NEUTRAL] Uh, yes, um, OK, 02572570.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And the name on the card is oh go ahead.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Oh, I was just gonna tell you that it's through the company my husband works for, so his name is probably the one that would pop up, [PII].
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] But it, the coverage is for family.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. Um, may I have your date of birth and the mailing address on file for security?
[CUSTOMER][NEUTRAL] Yes, uh, my date of birth is [PII], and the address is [PII].
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][POSITIVE] OK, let me look at the benefits really quick and see what we can.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be a minute. I'm waiting on the documents to pull up and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and again, this is a secondary supplemental plan to the major medical, so it's to help with the high deductible, co-payment, and co-insurance. And OK, so here's the list that covered under this plan. OK. So this one has inpatient and outpatient service. Um, the inpatient is when you're in the hospital, 18 hours or more, either in observation or hospitalized and you have up to $3000 per year.
[AGENT][NEUTRAL] For 6000 per family combined.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, for the outpatient benefits, um, that's $1000 per person per year or $2000 per family combined, and then you have an emergency room, um, deductible of $300.
[AGENT][NEUTRAL] OK. Um, the outpatient benefits, outpatient benefits can be used in the hospital emergency room, urgent care facility, surgery in a hospital, surgical center.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, diagnostic testing in a hospital or freestanding MRI or imaging facility?
[AGENT][NEUTRAL] Physical therapy facility, ambulance?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Cancer treatment, independent lab.
[AGENT][NEUTRAL] And treatment for a serious mental illness in a hospital, up to 60 days of treatment. So those are the benefits that you have under the outpatient. Uh, DME is not covered, so medical supplies are not gonna be covered under this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] That is exactly what I needed to know. So this card is basically used for any like hospital type emergency, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And, and a few outpatient like type things. So no um prescription, it's not a prescription.
[AGENT][NEUTRAL] Yes, like [PII].
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, got it. Alright, I think that's what I needed. I just, now, now I can just tell them that that it's not um an insurance that would cover any prescriptions.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm, right.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][POSITIVE] All right. Well, thank you so much. I appreciate your help.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] OK. Thank you for calling APL. You have a good day. Happy weekend.
[CUSTOMER][NEUTRAL] All right. You too. Bye.
[AGENT][POSITIVE] Thank you. Bye bye.